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Padma 28 for intermittent claudication


Morling, M.R., Maxwell, H. and Stewart, Marlene

Subject Keywords: To determine whether Padma 28 is effective, compared with placebo or other medications, in increasing pain-free and maximum walking distance for patients with intermittent claudication
Type: Article
Region: International (other)

Intermittent claudication (IC) is pain in the leg that occurs on exercise and is relieved by rest. It is caused by an inadequate blood supply to the legs due to blockage of arteries. Conservative drug treatment is commonly used in an attempt to improve walking distance in these patients. Padma 28 is a Tibetan herbal preparation used for treating intermittent claudication. This review on the effects of Padma 28 includes five trials with a total of 365 participants. The review showed that Padma 28 has some beneficial effects in improving maximum and pain-free walking distance. The groups treated with placebo did not show an improved maximum and pain-free walking distance. Unfortunately the studies reported insufficient data to allow the comparison of the change in walking distances in the Padma 28 group with the change in walking distances in the placebo group. Combining the data of maximum walking distance after treatment in two studies showed that there was a statistically significant longer maximum walking distance in the Padma 28 group compared with the placebo group (mean difference (MD) 95.97 m, 95% confidence interval (CI) 79.07 m to 112.88 m, P < 0.00001) after 16 weeks of treatment. No change in ankle brachial pressure was observed. Mild side effects such as gastrointestinal discomfort, tiredness and skin eruption were also noted but these were not statistically significant between the Padma 28 and placebo groups. Overall, the quality of the studies was moderate, with evidence of publication bias and attrition bias due to a high percentage of withdrawals in the placebo groups because of lack of improvement or deterioration of the overall condition. We therefore feel there is currently insufficient evidence to support the use of Padma 28 in the routine management of IC. Further well-designed research would be required to determine the true effects of this herbal preparation.



Rights: © The Cochrane Collaboration
Suggested citation:

Morling, M.R., Maxwell, H. and Stewart, Marlene. (2013) Padma 28 for intermittent claudication [Online]. Available from: [Accessed: 22nd July 2019].


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